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Islamic Perspectives on Organ Transplantation: a Continuous Debate

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Islamic Perspectives on Organ Transplantation: a Continuous Debate religions Article Islamic Perspectives on Organ Transplantation: A Continuous Debate Jan A. Ali School of Humanities and Communication Arts, Western Sydney University, Penrith, NSW 2751, Australia; [email protected] Abstract: From a medical perspective, as well as an ordinary human perspective, organ trans- plantation is often understood as a process through which health is restored to sick humans and, consequently, their quality of life improved. Organ transplantation is a medical surgical procedure carried out by an expert or a team of experts who remove a failing or diseased organ or organs from the human body and replace it or them with a functioning organ or organs. With such positive portrayal of the process, organ transplantation is highly recommended and encouraged in modern medicine. However, in Islam, the Qur’an and hadiths—the two great texts of the religion—are silent on the subject. In other words, there is no discussion of the subject in the texts and, therefore, it is not clear whether organ transplantation is permissible or not in Islam. Thus, is organ transplantation an accepted modality of treatment that eliminates the patient’s agony from end-stage organ failure, remains an open-ended question. Whilst some Muslim scholars and jurists argue in favour of organ donation and transplantation, there are others who reject the practice as a breach of shari’ah. This paper posits that the subject of organ donation and transplantation in Islam is an unresolved matter without a ubiquitous consensus. The purpose of the paper is to educate the readers about the two key perspectives on the subject, and highlight that more research and a robust academic and sociological debate are needed to resolve the question of organ donation and transplantation in Islam. Citation: Ali, Jan A. 2021. Islamic Keywords: organ transplantation; Islam; Qur’an; hadiths; shari’ah; modern medicine Perspectives on Organ Transplantation: A Continuous Debate. Religions 12: 576. https:// doi.org/10.3390/rel12080576 1. Introduction Academic Editor: Terry Lovat Recent medical advances made in the fields of organ procurement and organ transplan- tation have brought about new treatment regimes in patients and better management and Received: 29 June 2021 even cure of diseases. The West has become the leader in this medical field, making great Accepted: 22 July 2021 strides in disease control, management, and cure through a variety of medical means and Published: 27 July 2021 surgical procedures, including organ and tissue transplantation. With the advancements made in modern western medicine and technological innovations, organ transplantation is, Publisher’s Note: MDPI stays neutral for the first time in human history, taking place on a mass scale. Organ transplantation is a with regard to jurisdictional claims in medical surgical procedure undertaken by an expert or a team of experts who remove a published maps and institutional affil- failing or diseased organ or organs (or parts thereof) from the human body and replace it or iations. them with a functioning organ or organs. Although the transplantation in the modern era started in earnest in the 1940s (Scott 1981, p. 19) it was not until the discovery of effective immunosuppressive drugs in the late 1970s that the medical experts began to achieve great success in bone marrow, kidney, liver, thymus, cornea, pancreas, lungs, heart, intestine, Copyright: © 2021 by the author. uterus, and nerve cell transplantations, rendering organ transplantation a medical routinal Licensee MDPI, Basel, Switzerland. activity in the late twentieth and early twenty-first centuries. The surgical procedure is This article is an open access article performed to cure a disease and prolong life. In modern medicine, three types of organ distributed under the terms and transplantation are practiced: conditions of the Creative Commons i autograft or autotransplantation; Attribution (CC BY) license (https:// ii allograft or allotransplantation; creativecommons.org/licenses/by/ 4.0/). iii xenograft or xenotransplantation. Religions 2021, 12, 576. https://doi.org/10.3390/rel12080576 https://www.mdpi.com/journal/religions Religions 2021, 12, 576 2 of 16 The surgical procedure is performed to alleviate suffering, cure end stage disease, and prolong life. However, organ transplantation, certainly, is not a new phenomenon. In fact, autografting as a form of organ transplanting technique is a prehistoric phenomenon. Ancient Hindu surgeons used to apply it to repair noses damaged, for example, by syphilis, and ear defects caused, for instance, in warfare, using the neighbouring skin. The procedure is described in the classic Sanskrit text on medicine written by Susruta Sanhita in 6th century BC (Zhorne 1985, p. 10). However, the sociological and anthropological study of this phenomenon, particu- larly in the context of Islam, is one of the most under-researched areas. In Islam, organ transplantation and donation are not specifically discussed in the scriptures, namely the Qur’an and Hadith. Both of these two great texts of Islam are silent on the issue of organ transplantation and donation, and the debates surrounding organ transplantation and donation are only recently beginning to surface in Islamic scholarship (Ali 2019, p. 59). The Qur’an, Sunna (sayings and actions of Prophet Muhammad), and shari’ah (Islamic law) collectively have not addressed the question of organ transplantation, therefore inter- pretations and fatwas (nonbinding rulings on a point of Islamic law offered by a qualified jurist or a recognised authority) abound, and a unitary singular Islamic response to the topic remains absent. Additionally, as Islam differs from a Catholic papacy-type central authority, where doctrinal authority is centralized in the papacy, decision making in Islam takes place within the framework of multiple authorities with the ulama (religious scholars) and fuqaha (jurists) having important roles to play. Generally speaking, instructions can be found in Islam that direct its adherents to protect the body at all times and accord it care and attention during illness. Protection of the body and its treatment during illness is directly linked with the idea of preservation of life and account for a good deed. Many Islamic scholars, in light of this, view organ trans- plantation permissible in Islam. However, not all Islamic scholars and jurists necessarily agree with organ donation and transplantation. They consider organ transplantation and donation to be prohibited in Islam. Currently, no general consensus exists among Muslim scholars, including Muslim jurists, in the context of a specific Muslim-majority country or globally, on permissibility or impermissibility of organ donation and transplantation. The opinions are divided and can be located in one of the two overarching categories: i permissibility; ii impermissibility. Given the fact that the two great texts of Islam—Qur’an and hadith (recorded sayings and actions of the Prophet Muhammad)—as well as the shari’ah are silent on the issue of organ donation and transplantation, how, then, does Islamic faith reconcile itself with the progress and advancements made in different fields, including medicine, by humanity in time and space, i.e., in modernity? More specifically, how does Islamic faith engage with organ transplantation debates and practices? These are important questions in the sociology of Islam. It is important to note that organ donation and transplantation in their current forms are modern medical developments, born out of new scientific and medical discoveries and progress made not in Islamicate, but outside it, in the West. Muslims who have to face the possibility of having organ transplantations or making organ donations not only have to pay heed to Islamic theology and legal precepts, but also have to deal with the deep and extensive effects of organ transplantation involving donors, recipients, families, and medical professionals. Organ donation and transplantation, therefore, is not only a “private transaction” between the donor and recipient, but one that occurs within the context of an intricate nexus of relationships extending to incorporate families, friends, professionals, and members of Muslim community. Often seen as a very generous way of saving a life, organ donation through transplantation is also a very powerful gesture of “gift exchange” embodying strong social and cultural meanings. In this paper, I want to posit that the subject of organ donation and transplantation in Islam is an unresolved matter. The subject of organ donation and transplantation has Religions 2021, 12, 576 3 of 16 been exceedingly contested within Islam and a ubiquitous consensus is absent. Further research and more robust academic and sociological debate are needed, not only to resolve the question of organ donation and transplantation in Islam, but to do so on the basis of a mature and analytical understanding of different perspectives and issues surrounding the phenomenon. Various sensitive and complex issues are intertwined with the debate on organ dona- tion and transplantation and when employing the authority of the Qur’an, hadiths, and shari’ah in addressing the question of organ donation and transplantation, the matter of interpretation and the existence of multiple Islamic responses to the topic become appar- ent. With no central authority in Islam, a huge internal sectarian, and theological and ideological division in the ummah, a general consensus on matters of organ donation
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